| NPI | 1891523189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA D CLEARMAN Owner/Provider 601-480-4946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2024-07-26 |